Elucidating the Relationship between Neutrophil-Lymphocyte Ratio and Plaque Composition in Patients with Drug-Eluting
Ming Yu1, Yuxing Wang1, Song Yang1
1The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China.
Insights
High neutrophil-lymphocyte ratio (NLR) is linked to increased plaque burden and vulnerable components in in-stent restenosis (ISR). This finding identifies NLR as a risk factor for plaque load and fibro-lipid tissue in ISR, aiding clinical intervention marker identification.
Area of Science:
- Cardiology
- Biomarkers
- Vascular Biology
Background:
- In-stent restenosis (ISR) significantly impacts patient prognosis and revascularization outcomes.
- The precise plaque composition of ISR remains unclear, necessitating investigation for novel clinical intervention markers.
- Understanding ISR composition is critical for improving treatment strategies.
Purpose of the Study:
- To investigate the plaque composition of in-stent restenosis (ISR).
- To identify potential clinical intervention markers for ISR.
- To explore the relationship between neutrophil-lymphocyte ratio (NLR) and ISR plaque characteristics.
Main Methods:
- A study involving 36 patients with drug-eluting stent restenosis.
- Patients were categorized into Low Neutrophil-Lymphocyte Ratio (L-NLR) and High Neutrophil-Lymphocyte Ratio (H-NLR) groups based on median NLR.
- Multifactorial linear regression analysis was performed on plaque properties using virtual histology-intravascular ultrasound (VH-IVUS) data.
Main Results:
- Significant differences were observed between L-NLR and H-NLR groups in age, pre-PCI SYNTAX II score, C-reactive protein (CRP), interleukin-6 (IL-6), plaque burden, fibro-lipid tissue area, calcified nubs, and VH-TCFA.
- Multifactorial linear regression identified age, NLR, and IL-6 levels as significant factors influencing plaque stress and fibro-lipid tissue percentage.
- NLR was identified as a risk factor for both plaque load and the proportion of fibro-lipid tissue in ISR.
Conclusions:
- The high NLR group exhibited increased myocardial injury severity, higher SYNTAX II scores, greater plaque burden, and a higher proportion of vulnerable plaque components.
- Neutrophil-lymphocyte ratio (NLR) is a significant risk factor for plaque load and fibro-lipid tissue content in in-stent restenosis.
- These findings highlight the potential of NLR as a biomarker for assessing ISR severity and composition.
Abstract:
(1) Background: In-stent Restenosis (ISR) is a major factor influencing the prognosis and revascularization of target lesions. The plaque composition is unclear; therefore, it is critical to investigate ISR composition to identify clinical intervention markers. (2) Methods: This study was conducted on 36 patients with drug-eluting stent restenosis. The patients were classified into a Low Neutrophil-Lymphocyte Ratio (L-NLR) and High Neutrophil-Lymphocyte Ratio (H-NLR) according to the median NLR level of 36 patients. Discrepancies in the current information such as baseline data, biochemical examination, cardiac ultrasound data, etc., were examined to identify the underlying risk factors, and a multifactorial linear regression analysis of plaque properties was conducted. (3) Results: NLR = 2.64 was utilized to classify 18 patients into the L-NLR group and 18 patients into the H-NLR group. There were statistically significant differences in age, a pre-percutaneous coronary intervention (PCI) SYNTAX II score, a C-reactive protein (CRP), interleukin (IL)-6, plaque loading, a fibro-lipid tissue area, calcified nubs, and virtual histology-thin fibrous cap atherosclerotic (VH-TCFA). The significant impacts of variations in age, neutrophil-lymphocyte ratio (NLR) levels, and IL-6 levels on the plaque stress and percentage of the fibro-lipid tissue in virtual histology-intravascular ultrasound (VH-IVUS) were identified through multifactorial linear regression. (4) Conclusions: The high NLR group demonstrated increased myocardial injury severity, consistent with higher SYNTAX II scores, a higher plaque burden, and higher proportions of vulnerable components. NLR proved to be a risk factor for both the plaque load and the proportion of the fibro-lipid tissue in ISR.
